Numbers Crunch
The ABA is concerned that legislation being considered by Congress would impose limits on federal funding available to help cover the costs of legal services for AIDS patients.
The Bush administration has proposed that a new funding formula be incorporated into legislation that would reauthorize the Ryan White Comprehensive AIDS Resources Emergency Act. (The law is named for Ryan White, who died in April 1990 at the age of 18 after contracting AIDS from tainted blood he received from transfusions.)
The administration’s formula would require that 75 percent of federal funding under the CARE Act be restricted to a core set of medical services for individuals with AIDS or HIV, the precursor to the disease. Federal funding for social services—including assistance with legal matters—not deemed essential to maintaining physical and mental health of HIV/AIDS patients would be capped at 25 percent of funding available under the CARE Act. (Meanwhile, the president has requested $2.1 billion in total funding for CARE Act programs in fiscal 2007, a 5 percent increase from fiscal 2006.)
The administration describes the proposed funding formula as part of an effort to respond to the changing demographics of AIDS. But the ABA is urging Congress to reject the proposed formula on grounds that legal services are vital to individuals with AIDS or HIV, and to wider AIDS-prevention efforts.
The proposed funding cap would be devastating, says Richard T. Andrias, an associate justice in the New York Supreme Court’s appellate division in New York City. He is a founding member and current chair of the AIDS Coordinating Committee in the ABA Section of Individual Rights and Responsibilities.
“Legal services are critical to preserving access to employment, housing, health care, public benefits, you name it—all of the things that are an integral part of preserving the overall well-being of an HIV-infected person,” says Andrias. “Without those legal services, many of which rely on Ryan White [Act] funding, that person’s condition can quickly deteriorate, exposing him or her to various forms of discrimination, driving the epidemic underground and leading to the further spread of HIV.”
In May, the Senate’s Health, Education, Labor and Pensions Committee approved a CARE Act reauthorization bill (S. 2823) that includes the administration’s funding formula. In the House, an energy and commerce subcommittee is preparing a version of the bill after holding hearings earlier this year.
CHANGING LANDSCAPE
Since 1990, the Care Act has provided funding to metropolitan areas, states, territories and private organizations according to a set of formulas that are based on population and the number of reported AIDS cases.
But conditions have changed since those formulas were developed. Improvements over the past few years in treatment for HIV/AIDS have led to declines in AIDS deaths across the United States and increased life expectancy for individuals with the disease or who are HIV- positive. AIDS, once confined largely to the gay community, now occurs disproportionately among racial and ethnic minorities, and is increasingly affecting women.
Moreover, although the highest proportion of people with HIV/AIDS in the United States live in the Northeast and the epidemic continues to be concentrated in urban areas, many members of Congress, including Senate bill sponsor Michael B. Enzi, R-Wyo., maintain that the number and location of HIV/AIDS cases is not accurately reflected in the current law. They say rural areas need more CARE Act funding. Enzi’s bill would alter funding formulas to accomplish that.
This column is written by the ABA Governmental Affairs Office and discusses advocacy efforts by the ABA relating to issues being addressed by Congress and the executive branch of the federal government.
Rhonda McMillion is editor of Washington Letter, an ABA Governmental Affairs Office publication.
